title: Reversed root for entirely biological aortic valve and ascending aorta replacement in a patient with endocarditis and mediastinitis.
abstract: A 59-year-old patient developed endocarditis with coagulase-negative staphylococci after aortic composite graft replacement and pacemaker implantation. She underwent complete pacemaker removal and tricuspid valve reconstruction. Pus was present in and around the aortic graft. Re-replacement of the aortic root and ascending aorta using only biological material was performed. A 23-mm full root stentless prosthesis (Vascutek Root Elan, Vascutec, Terumo, Leeds, UK) was used for aortic root replacement, and a second 25-mm full root prosthesis with removed cusps implanted in a reversed fashion was used for ascending aorta and proximal aortic arch replacement.
authors.affiliation: Department of Cardiovascular Surgery, Heart Center Brandenburg, Bernau, Germany. j.albes@immanuel.de
authors.forename: J M
authors.initials: JM
authors.lastname: Albes
authors.forename: T
authors.initials: T
authors.lastname: Claus
mesh_terms: D001014:Aortic Aneurysm / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000601:surgery; D054537:Atrioventricular Block / Q000628:therapy; D001705:Bioprosthesis; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D020878:Device Removal; D004697:Endocarditis, Bacterial / Q000382:microbiology / Q000601:surgery*; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D006801:Humans; D008480:Mediastinitis / Q000382:microbiology / Q000601:surgery*; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D011474:Prosthesis Design; D016459:Prosthesis-Related Infections / Q000382:microbiology / Q000601:surgery*; D012086:Reoperation; D013210:Staphylococcus / Q000302:isolation & purification; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000382:microbiology / Q000601:surgery*